Self-harm Behaviors Research Articles

Risk and protective factors for self-harm and suicide behaviours among serving and ex-serving personnel of the UK Armed Forces, Canadian Armed Forces, Australian Defence Force and New Zealand Defence Force: A systematic review.

Self-harm and suicide behaviours are a major public health concern. Several factors are associated with these behaviours among military communities. Identifying these factors may have important implications for policy and clinical services. The aim of this review was to identify the risk and protective factors associated with self-harm and suicide behaviours among serving and ex-serving personnel of the United Kingdom Armed Forces, Canadian Armed Forces, Australian Defence Force and New Zealand Defence Force. A systematic search of seven online databases (PubMed, Web of Science, Embase, Global Health, PsycINFO, PTSDpubs and CINAHL) was conducted alongside cross-referencing, in October 2022. Following an a priori PROSPERO approved protocol (CRD42022348867), papers were independently screened and assessed for quality. Data were synthesised using a narrative approach. Overall, 28 papers were included: 13 from Canada, 10 from the United Kingdom, five from Australia and none from New Zealand. Identified risk factors included being single/ex-relationship, early service leavers, shorter length of service (but not necessarily early service leavers), junior ranks, exposure to deployment-related traumatic events, physical and mental health diagnoses, and experience of childhood adversity. Protective factors included being married/in a relationship, higher educational attainment, employment, senior ranks, and higher levels of perceived social support. Adequate care and support are a necessity for the military community. Prevention and intervention strategies for self-harm and suicide behaviours may be introduced early and may promote social networks as a key source of support. This review found a paucity of peer-reviewed research within some populations. More peer-reviewed research is needed, particularly among these populations where current work is limited, and regarding modifiable risk and protective factors.

Dual harm: Violent behaviour to others and self-harm behaviour in adults compulsorily admitted to a Dutch psychiatric hospital

BackgroundVerbal and physical violence in psychiatric hospitals can have harmful consequences for staff members, such as physical injury, traumatisation, and sick leave, and they often accompany involuntary admission. Harm to others may co-occur with self-harm, i.e., dual harm. However, little is known about the association between dual-harm and violent behaviour towards staff members and its clinical outcomes, such as seclusion and rapid tranquilisation after involuntary admission to a psychiatric inpatient unit. MethodA convenience sample of patients admitted involuntarily (N = 384; mean age = 48.03, SD = 19.92) between January 2016 and December 2019 in Western Brabant, the Netherlands, was used to design a retrospective file audit. Distinct harm groups, marked by the presence/absence of self- and/or other-harm, were investigated using multivariate linear regression modelling on the seriousness of violent acts and the total length of admission. Logistic regression analyses were used to study the association between harm groups and the administration of rapid tranquilisation, seclusion, and extended involuntary admissions. ResultsSeveral harm groups were identified, including self-harm only, other-harm only, and dual-harm groups. Psychiatric patients admitted to the hospital because of (the risk of) violence towards others had a higher risk of violent incidents during admission and some restrictive measures. In a subgroup of patients with psychotic disorders, patients with dual harm committed the most serious violent incidents compared to those in the other harm groups. ConclusionDistinct harm groups were identified in a sample of involuntarily admitted patients. In a general adult psychiatric setting, patients at risk for violent behaviour, especially dual-harm patients, should be identified and monitored as part of the risk assessment. Future research is needed to explore more clinical correlates in the proposed distinction between harmful groups and to assess long-term prognosis.

Developmental Trajectories of Mental Health in Chinese Early Adolescents: School Climate and Future Orientation as Predictors.

There is growing support for the dual-continua model of mental health, which emphasizes psychopathology and well-being as related but distinct dimensions. Yet, little is known about how these dimensions co-develop from childhood to early adolescence and what factors predict their different trajectories. The current study aimed to identify distinct patterns of mental health in Chinese early adolescents, focusing on both psychopathological symptoms (i.e., depressive symptoms and self-harm behaviors) and subjective well-being (i.e., life satisfaction and affect balance). This study also examined the contributions of school climate and future orientation to these trajectories. A total of 1,057 students (Mage = 11.88, SDage = 1.67; 62.1% boys) completed four assessments over two years, with six-month intervals. Using parallel-process latent class growth modeling, we identified four groups: Flourishing (32.5%), Languishing (43.8%), Troubled with Stable Depressive Symptoms (16.1%), and Troubled with Increasing Self-Harm Risk (7.6%). Furthermore, school climate and future orientation contributed to adolescents' membership in these trajectories, either independently or jointly. Specifically, higher levels of future orientation combined with higher school climate were associated with a lower likelihood of belonging to the Troubled with Increasing Self-Harm Risk trajectory, compared to the Flourishing group. Our findings identified four distinct mental health trajectories consistent with the dual-continua model, and demonstrated that the development of psychopathology and well-being were not always inversely related (e.g., the Languishing group). Adolescents with unique developmental profiles may benefit from tailored intervention strategies that build on the personal and environmental assets of the adolescent.

Animal-Assisted Dialectical Behavior Therapy Skills Groups for Those who are Incarcerated: A Pre-Post-test Study

Incidents of self-harm present significant concerns in correctional facilities. Purpose: Developing interventions to address self-injury is beneficial to individuals who are incarcerated as well as the security personnel in charge of their care and custody. Method: Four 6-week animal-assisted dialectical behavior therapy (DBT) skills groups were provided to men and women incarcerated in a jail. Each group integrated two therapy dogs while participants utilized a workbook to assist in the application of DBT skills. A total of 23 participants completed the program. Results: Participants demonstrated a statistically significant decrease in self-harming behaviors. Discussion: All participants indicated that the presence of therapy dogs was helpful as they provided comfort/support, calming/coping, and focus. The receptivity to groups and the results offer support for enhancing treatment in correctional facilities.

Depressive symptoms and neuroticism mediate the association between traumatic events and suicidality - A latent class mediation analysis of UK Biobank Database

BackgroundMental disorders that follow traumatic experience may increase risk of suicidality, but a comprehensive approach to understand how these mental disorders mediate the association between psychological traumatic experience and suicidality should be elucidated. In this study, we attempted to provide comprehensive evidence on how depressive symptoms and neuroticism can mediate the association between psychological traumatic experiences and suicidal behaviours including suicidal ideation, suicidal planning, and suicide attempts. MethodsWe analyzed 111,931 participants from UK Biobank who had completed mental health web-based questionnaire from 2016 to 2017. “Self-harm and suicidal behaviour and ideation (SSBI) score” was calculated by the response from suicidal behaviours and self-harm questionnaires. Conducting multivariate linear regression, depressive symptoms, anxiety symptoms, and neuroticism were selected as potential mediators. We constructed a latent class mediation model estimated direct effect of psychological traumatic events on suicidality and indirect effect of psychological traumatic events mediated by depressive symptoms and neuroticism. ResultsPsychological traumatic events were positively associated with suicidal behaviours. Depressive symptoms and neuroticism significantly mediated the effect of psychological traumatic events on suicidality. Anxiety symptoms did not mediate the association between psychological traumatic events and suicidality. ConclusionPsychological traumatic events, irrespective of life stage of occurrence, are associated with suicidality. The association between psychological traumatic events and suicidality can be partially explained by depressive symptoms and neuroticism of those who were exposed to psychological trauma.

Subjective distress, self-harm, and suicidal ideation or behavior throughout trauma-focused cognitive-behavioral therapy in transitional age youth.

Elevations in distress, self-harm, and suicidal ideation or behavior are of significant concern in clinical practice. We examined these in a pilot trial of Trauma Focused-Cognitive Behavioral Therapy (TF-CBT) for transitional age youth (aged 15-25 years) with histories of interpersonal trauma and symptoms of posttraumatic stress disorder. Participants were 20 young people (13 females, M = 19.5 years) from a pilot study of TF-CBT. Frequencies of elevated distress, self-harm, and suicidal ideation or behavior were measured throughout treatment sessions and across the treatment phases of TF-CBT. Across the 279 sessions of TF-CBT (m = 15.5 sessions), there were 16 incidents of elevated distress in seven participants (i.e., six in Phase I and five each in Phases II and III); 15 incidents of self-harming behavior in seven participants (five incidents in each of the three phases) and one incident of both elevated distress and suicide ideation (Phase I). Findings indicate that there may be a relationship between the experience of in session distress and self-harming behaviors. The importance of safety planning and coping skills (acquired in Phase 1) is stressed to ensure the effective implementation of TF-CBT. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Suicidality and Self-harm Behavior of Adolescents During the Early Phase of the War in Ukraine

War profoundly impacts people's lives, causing death, displacement, and psychological trauma, but research investigating suicidality of adolescents in this context has been limited. We compared suicidality or self-harm behavior among adolescents in regions that were, and were not, affected by Russia's initial invasion of Ukraine in2014. This cross-sectional study comprised 2,752 school students aged 11 to 17 years from the war-affected Donetsk region and non-war Kirovograd region. Data collection occurred in 2016 and 2017 using self-report tools to assess suicidality or self-harm behavior; psychopathology including posttraumatic stress disorder (PTSD), depression, and anxiety; and war trauma exposure. Adolescent girls in the war-affected region reported more suicide attempts (9.5% vs 5.1%; adjusted odds ratio [aOR] 1.8, 95% CI 1.2-2.8), suicidal ideation (39.3% vs 19.6%; aOR 2.6, 95% CI 2.01-3.3), or self-harm behavior (19.6% vs 13.1%; aOR 1.6, 95% CI 1.2-2.1), and boys reported more suicidal ideation (17.0% vs 9.8%; aOR 1.7, 95% CI 1.2-2.4). Boys and girls with PTSD, depression, or anxiety showed increased risks for any suicidality or self-harm. A dose-effect relation was observed between war trauma exposure and suicidality or self-harm. The association was strongest for adolescents who had experienced 5 or more different war trauma exposures (aOR 3.2, 95% CI 2.2-4.8). War trauma exposure and psychopathology were strongly associated with suicidality or self-harm behavior, with a greater impact in girls than boys. The high prevalence of suicidality found in this study emphasizes the need for intervention on a large scale for adolescents living in war situations.

Self-harm among Brazilian teenagers: scoping review

IntroductionNon-suicidal self-injury among adolescents has grown in recent years, becoming a significant public health issue. The high social and psychological impacts related to it are often characterized by substance abuse and the development of anxiety and depression. Furthermore, emotional dysregulation and heightened reactivity are associated psychological characteristics.ObjectivesThe aim of this paper was to do a scoping review, mapping the existing literature on self-harming behaviors among Brazilian adolescents, considering their sociodemographic and clinical characteristics.MethodsWe followed the adapted PRISMA checklist for scoping reviews. We searched eight databases: APA PsycNet, LILACS, MEDLINE, PubMed, Embase, Web of Science, The Cochrane Library, and Scopus. The selection of studies was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, where three independent researchers examined all titles and abstracts, applying the eligibility criteria. Accordingly, six studies were selected for descriptive analysis due to the variety of study types.ResultsA total of 2,032 youngsters were studied in the age range of 10 to 19 years-old, among over 15,000 reported cases of self-harming behaviors. Females accounted for 51.3% of the cases and had higher scores of impulsivity and loneliness to self-harming behavior (P ≤ 0.05). Alcohol use was evident across both genders but showed higher measures for males in both age groups (10 to 14 and 15 to 19 years, p < 0.001).Image:Image 2:Image 3:Conclusions The study pointed to a diversity of clinical and sociodemographic characteristics; however further research is needed on this topic on Brazilian adolescents. In addition, a broader standardization of data is necessary for more specific statistical analyses.Disclosure of InterestNone Declared

Self-harm in sexually abused adolescents: The role of posttraumatic symptoms, emotional impulsivity, and negative cognition.

Posttraumatic symptoms, emotional impulsivity, and negative cognition have been proposed as pathways in explaining why individuals have experienced trauma are at increased risk for self-harm. The present study examined whether emotional impulsivity (i.e., negative and positive urgency) and negative cognition (i.e., personal attribution and feeling different from peers) mediate the path from posttraumatic symptoms to self-harm in sexually abused adolescents, a population at the highest risk for self-harm. One hundred and thirty-one sexually abused youths aged 10-18 years in South Korea completed the Self-Harm Inventory, UPPS-P (urgency-premeditation-perseverance-sensation seeking-positive urgency) Impulsive Behaviors Scales for use with children, and Children's Attribution and Perception Scale, and their parents completed the Korean version of the parent report of posttraumatic symptoms. Among the adolescent participants, 77.1% (n = 101) reported engaging in at least one self-harm behavior, and 61.8% (n = 81) reported engaging in deliberate self-injury. Mediation model analyses showed that parent-reported posttraumatic symptoms predicted more self-harm behaviors among sexually abused adolescents. The indirect effect of parent-reported posttraumatic symptoms on self-harm through adolescents' negative cognition was significant, but the indirect effect through emotional impulsivity was not. The results indicate that, at least among sexually abused adolescents, posttraumatic symptoms lead to self-harm via negative cognition rather than increased emotional impulsivity. These findings suggest that sexually abused adolescents suffering from posttraumatic symptoms are more likely to engage in self-harm in response to negative cognition of themselves and the world rather than as an impulsive response to intense emotions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Is a smartphone application (BlueIce) acceptable and safe for university students who self-harm: an open study

BackgroundMany university students self-harm but few receive support. Smartphone apps have been identified as acceptable sources of support for students who self-harm, but the use of supportive self-harm apps is...

Attention deficit hyperactivity disorder in adults : prevalence and association with addictive disorders

Introduction Attention deficit hyperactivity disorder (ADHD) is a neurobehavioral disorder witch assumed to be a disorder of childhoood but recently has been shown to persist into adulthood. As in children, core features of adult ADHD include inattention, impulsivity, and/or hyperactivity.Despite growing interest in adult ADHD, little is known about its prevalence or correlates.ObjectivesWe aimed to estimate the prevalence of ADHD in adult outpatient psychiatric care at the university hospital of Gabes (southern Tunisia) and to explore its association with addictive disorders.MethodsWe conducted a cross-sectional, descriptive, and analytical observation study,in the outpatient psychiatry department of the Gabes university hospital, during the period ranging from 1/1/2023 to 30/06/2023. We used an anonymous pre-established information sheet exploring the socio-demographic, clinical, therapeutic data of the patients, lifestyle habits and substance use, the DSM-5 to classify diagnoses, CGI-S to rate the severity of overall mental illness, Fagerström test to assess the nicotine dependence, Adult ADHD Self-Report Scale (ASRS) in its validated Arabic version to screen ADHD and the Diagnostic Interview for ADHD in Adults (DIVA) to confirm the ADHD diagnosis. Data entry and analysis were performed using Statistical Package for Social Sciences (SPSS) version 21.0.Results The response rate in our study was around 64.5%, 205 patients were included.The mean age of the patients was 48years ±14.9, the male/female ratio was 1.The estimated prevalence of adult ADHD according to the DIVA was 5.9% (male/female ratio=1/2). At the uni-variate study, significant associations were found between ADHD and the age category (p=0), the marital status (OR=0.14; CI [0.03- 0.55], p=0.003), theFagestrom score (p=0.01), cannabis consumption (OR=19; CI [1.8-201], p=0.018), psychotropic drugs consumption (OR=39; CI[3-196], p=0.02), self-harm behavior (OR=6.9, CI[1.9-26], p=0.01), excessive use of internet and screens (OR=38, CI[7-179],p=0). At the multivariate study, two determining factors were found: cannabis consumption(OR=8 [1- 58]; p=0.031), and the excessive use of internet and screens (OR=25 [4-144]; p=0).Conclusions Regarding our findings and the important prevalence of the adult ADHD,more efforts are needed to increase the detection and treatment of this disorder, in order to set up an early intervention before major impairments and complications become irreversible.Disclosure of InterestNone Declared

Revealing complexity: beyond the whole—segmentation of hippocampal subfields in adolescents with depression and its relationships with cognition

IntroductionThe occurrence of depression in adolescence, a critical period of brain development, linked with neuroanatomical and cognitive abnormalities. Neuroimaging studies have identified hippocampal abnormalities in those of adolescent patients. However, few studies have investigated the atypically developmental trends in hippocampal subfields in adolescents with depression and their relationships with cognitive dysfunctions.ObjectivesTo explore the structural abnormalities of hippocampal subfields in patients with youth depression and examine how these abnormalities associated with cognitive deficits.MethodsWe included a sample of 79 first-episode depressive patients (17 males, age = 15.54±1.83) and 71 healthy controls (23 males, age = 16.18±2.85). The severity of these adolescent patients was assessed by depression scale, suicidal risk and self-harm behavior. Nine cognitive tasks were used to evaluate memory, cognitive control and attention abilities for all participants. Bilateral hippocampus were segmented into 12 subfields with T1 and T2 weighted images using Freesurfer v6.0. A mixed analysis of variance was performed to assess the differences in subfields volumes between all patients and controls, and between patients with mild and severe depression. Finally, LASSO regression was conducted to explore the associations between hippocampal subfields and cognitive abnormalities in patients.ResultsWe found significant subfields atrophy in the CA1, CA2/3, CA4, dentate gyrus, hippocampal fissure, hippocampal tail and molecular layer subfields in patients. For those patients with severe depression, hippocampal subfields showed greater extensive atrophy than those in mild, particularly in CA1-4 subfields extending towards the subiculum. These results were similar across various severity assessments. Regression indicated that hippocampal subfields abnormalities had the strongest associations with memory dysfunction, and relatively week associations with cognitive control and attention. Notably, CA4 and dentate gyrus had the highest weights in the regression model.ConclusionsAs depressive severity increases, hippocampal subfield atrophy tends to spread from CA regions to surrounding areas, and primarily affects memory function in patients with youth depression. These results suggest hippocampus might be markers in progression of adolescent depression, offering new directions for early clinical intervention.Disclosure of InterestNone Declared

Enhancing Arabic offensive language detection with BERT-BiGRU model

With the advent of Web 2.0, various platforms and tools have been developed to allow internet users to express their opinions and thoughts on diverse topics and occurrences. Nevertheless, certain users misuse these platforms by sharing hateful and offensive speeches, which has a negative impact on the mental health of internet society. Thus, the detection of offensive language has become an active area of research in the field of natural language processing. Rapidly detecting offensive language on the internet and preventing it from spreading is of great practical significance in reducing cyberbullying and self-harm behaviors. Despite the crucial importance of this task, limited work has been done in this field for nonEnglish languages such as Arabic. Therefore, in this paper, we aim to improve the results of Arabic offensive language detection without the need for laborious preprocessing or feature engineering work. To achieve this, we combine the bidirectional encoder representations from transformers (BERT) model model with a bidirectional gated recurrent unit (BiGRU) layer to further enhance the extracted context and semantic features. The experiments were conducted on the Arabic dataset provided by the SemEval 2020 Task 12. The evaluation results show the effectiveness of our model compared to the baseline and related work models by achieving a macro F1- score of 93.16%.

Examining strength at home couples to prevent intimate partner violence on a military installation: A randomized controlled trial.

In this study, the effectiveness of a couples-based group intervention to prevent intimate partner violence (IPV), Strength at Home Couples (SAH-C), was examined on a military installation relative to a comparison intervention, Supportive Prevention (SP). It was expected that greater reductions in use of physical, psychological, and sexual IPV behaviors, as well as reduced suicidality, would be found among service members and their partners in SAH-C relative to SP. Participants included 138 couples randomized to SAH-C and SP through a clinical controlled trial embedded in a hybrid effectiveness implementation study which took place on a military installation. The Revised Conflict Tactics Scales and Multidimensional Measure of Emotional Abuse were used to measure IPV, and 13 Military Suicide Research Consortium common data elements were used to assess suicidality. Service members randomized to SAH-C evidenced greater reductions based on effect sizes across the assessment time points for all IPV variables, including use of overall physical IPV, severe physical IPV, sexual IPV, psychological IPV, and coercive control IPV relative to those randomized to SP. Partners of service members demonstrated a similar general pattern for reductions in use of IPV, but findings were not as robust as for service members. Both service members and partners demonstrated greater reductions in suicidality based on effect sizes when randomized to SAH-C relative to SP. Findings extend prior work demonstrating the promising effects of SAH-C delivered in the military context and highlight the possible benefits of SAH-C in preventing self-harm thoughts and behaviors. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The relationship between non-suicidal self-injury and suicidal ideation in patients with borderline personality disorder treated at the Arrazi psychiatric hospital in Salé

IntroductionNon-suicidal self-harm, i.e. the intentional self-infliction of bodily harm without apparent suicidal intent, is a powerful risk factor for suicidal ideation and behavior [1]. Although non-suicidal self-harm and suicidal behaviour are distinct concepts, the two forms of deliberate self-harm frequently coexist and share key instrumental functions, such as escaping aversive internal states, reducing dysphoria or communicating distress, especially in patients with personality disorders. [2]Some individuals also report using non-suicidal self-harm to ameliorate suicidal thoughts or urges [2].ObjectivesTo assess the relationship between non-suicidal self-harm and suicidal ideation in patients with borderline personality disorder followed at the Arrazi psychiatric hospital in Salé.MethodsThis was a descriptive cross-sectional study using a questionnaire including sociodemographic criteria, clinical criteria and the Beck suicidal intentionality scale to assess the relationship between non-suicidal self-harm and suicidal ideation in patients with borderline personality disorder followed and hospitalised at the Arrazi psychiatric hospital in Salé.The inclusion criteria were as follows: both sexes with a diagnosis of borderline personality disorder according to DSM 5 criteria.Exclusion criteria were current psychosis and severe intellectual disability.ResultsWe collect 63 participants.The average age of the participants was 23, and they were predominantly female (89%). About 85% were single and 97% had no occupation. The majority of participants had a substance use disorder.All participants had a history of non-suicidal self-harm and 36% had a history of suicide attempts.Suicidal intent was strong in 45% of participants who had already attempted suicide.Approximately 46% of participants reported that non-suicidal self-harm was intended to alleviate suicidal ideation and approximately 27% of participants reported having experienced suicidal ideation shortly after non-suicidal self-harm.Conclusions Non-suicidal self-harm is very common in patients with borderline personality disorder often considered to have a mitigating effect on the internal stress of these patients and sometimes even neglected. The relationship between non-suicidal self-harm and suicidal ideation is an important one, and may reduce suicidal ideation in the short term but subsequently encourage further self-harm, thereby increasing the risk of suicide.Particular attention must be paid to these patients and their self-harm, and specialised, comprehensive care is required.Disclosure of InterestNone Declared

Narcissistic predispositions of self-harm in young women with and without depression

Introduction Diagnostic criteria for narcissistic personality disorder primarily focus on grandiosity and significance. In psychotherapeutic work, it is important to distinguish two subtypes of pathological narcissism: narcissistic grandiosity and narcissistic vulnerability. One of the manifestations of narcissistic traits is unstable or unformed self-esteem, manifested in attempts to conform to ideals. A part of modern society perceives the female body as an object that “needs to be looked at”. Self-objectification refers to a learned pattern of self-assessment of the importance of one’s body and appearance compared to other aspects of the self. Self-observation and comparison of oneself with others is one of the manifestations of self-objectification. With acts of auto aggression, the body becomes a tool or a means to solve psychological problems. In order for this to become possible, the ability to objectify your body “to look at it from the outside” plays an important role.ObjectivesAnalysis of the relationship between non-suicidal self-injurious behavior and narcissistic personality traits in young women with depression and young women without a psychiatric diagnosis.MethodsТhe study included 49 women divided into two groups. The first group included 24 patients with depression undergoing inpatient treatment (mean age 18.4). The second group included 25 healthy subjects (mean age 18 years). The methods: The answer to the question “Sometimes I purposely injure myself” was used as an indicator of self-harm (NSSI) (five-point Likert scale); “Ich structure test” (ISTA); “Physical Appearance Comparison Scale-Revised” (PACS-R).Results In the clinical group, a significant association of severity of NSSI with indicators of “deficit narcissism” was revealed (Spearman r=,534*). Correlations were found between the severity of NSSI and PACS-R (r=,344**). In the clinical group, there was no connection between “Comparison with others” and narcissistic traits. In a group of healthy subjects, significant associations of NSSI severity with “destructive narcissism” (,572**) and PACS-R (,576**) were revealed. In the clinical group, the severity of NSSI is associated with a more serious pathology - the lack of formation of “normal” narcissism, and in the healthy group it is more likely to be deformed narcissism. Self-objectification and comparison of oneself with others in the clinical group is not associated with manifestations of narcissistic traits, such connections are demonstrated in the group of healthy young women.ConclusionsIt is shown that in the clinical group of depressed young women, the severity of self-harming behavior is associated with “deficit narcissism”, and in healthy young women, first of all, with “destructive narcissism” with an increased need to compare themselves with others.Disclosure of InterestNone Declared

Pharmacotherapy and psychotherapy interventions in patients with borderline personality disorder in outpatient clinical practice

IntroductionDespite the high prevalence of borderline personality disorder (BPD) in the population, the evidence regarding approaches to therapy for BPD is inconsistent. No psychopharmacological medications are approved for the treatment of BPD, yet most patients with BPD are treated with pharmacotherapy. Meanwhile, psychotherapy is the method of choice for the treatment of BPD. Little is known about the clinical practice of BPD treatment in Russia, since most studies have been conducted in Western countries.ObjectivesThe aim of the study: analysis of approaches to treatment of BPD in real outpatient clinical practice in Saint-Petersburg, Russia.MethodsFifty patients (72% female; n=36; mean age 22.4±4.3) who were treated in an outpatient community care were included in the study. Diagnosis was made according to the ICD-10 criteria (F60.31), as it does in clinical practice in Russia. Research methods included a clinical-catamnestic method.ResultsAll examined patients received pharmacotherapy. Twenty-four patients (48.0%) received monotherapy with a selective serotonin reuptake inhibitor antidepressant. The remaining patients (52.0%) received two or more psychotropic medications simultaneously. The most frequent combination of psychopharmacotherapeutic agents was a combination of an antidepressant and a mood stabilizer. Analysis of therapy revealed that antipsychotics (always of the second generation) as well as mood stabilizers were prescribed to target emotional instability and impulsivity as symptoms of BPD, as well as increased self-harming behavior in order to reduce impulsivity. Despite the assumption that the simultaneous prescription of several medications to patients with BPD was due to the presence of a comorbid psychiatric diagnosis, this was not confirmed (p>0.05). Most of the patients (n=42; 84.0%) received individual and group psychotherapy (cognitive-behavioral with elements of dialectical-behavioral therapy). It was found that patients who received psychotherapy had a faster response to pharmacotherapy (p<0.05).ConclusionsAn analysis of approaches to the treatment of BPD in outpatient clinical practice in Saint-Petersburg, Russia, showed a predominance of medication-assisted psychopharmacotherapy (selective serotonin reuptake inhibitors, antipsychotics, mood stabilizers) over the frequency of prescription of psychotherapeutic care. In none of the cases was a first-line psychotherapy method (with proven efficacy for BPD) used. An assessment of the availability of psychotherapeutic care for patients with BPD is required. An earlier initiation of psychotherapeutic care after the BPD diagnosis is recommended, which may lead to an increase in the effectiveness of psychiatric care for patients with BPD in outpatient clinical practice.Disclosure of InterestNone Declared

The Epidemic of Non-Suicidal Self-Harm in Adolescents and Young Adults in the Kyrgyz Republic

Introduction During the last two years, many young people and adolescents in the Kyrgyz Republic started to visit specialists due to Non-suicidal self-harm. A significant rise in the amount of such cases allowed specialists from the Republican Center of Psychiatry in Bishkek to think about an “epidemic “of self-harming behavior. Non-suicidal self-harm (NSSH) is defined as repeated, deliberate, direct injury to the body without suicidal intent that is not socially acceptable (Nixon et al., 2002) to reduce psychological discomfort in the absence of a conscious intention to take one’s life (ICD-10 codes X60-X84, and ICD-11 codes PB80-PD3Z).ObjectivesTo determine the causes of NSSH among adolescents and young adults who approached specialists in mental health sphere at Institute of Behavioral Health at the American University of Central Asia.MethodsOver two years, forty-five adolescents and young adults under twenty-five who had committed self-harm visited specialists from the Behavioral Health Institute at the American University of Central Asia.All the patients received either dialectical behavioral treatment or cognitive processing treatment, medication (paroxetine) was used in three cases.ResultsThirty patients were girls under twenty-one, and fifteen were boys and young male adults. The overwhelming majority (40 people) had self-inflicted cuts, two had imposed burns with matches and cigarettes, and one had used self-suffocation without a bond. Reasons for self-harm were the following: releasing internal tension and anxiety, getting some rest from intrusive thoughts, relieving the inner pain, and a desire to “feel as a whole person.” All the patients underlined that they did not want to attract attention from their family members; moreover, they tried to hide the consequences of self-harm. Teens and young adults (twelve patients) from Kyrgyz traditional families visited a consultant or psychiatrist after a long drive through conventional or religious healers. All of the patients knew that they were addicted to self-harm, wanted to stop a problematic behavior, and could not stop it on their own. Ten patients have been diagnosed with borderline personality disorder. Two of them also had eating disorders. Five patients had PTSD, and five had social phobia. The others had recognizable anxiety symptoms.ConclusionsThe enormous rise of non-suicidal self-harm is a phenomenon that needs further research. Those cases often resist treatment due to the “addictive” component in the pathogenesis.Disclosure of InterestNone Declared

비자살적 자해행동 청소년의 푸드아트테라피 사례

This study is a case study of the forgiveness experience of food art therapy foradolescents with non-suicidal self-injurious behavior. We would like to examine changesin whether adolescents with non-suicidal self-injurious behavior can reduce or stop theirself-injurious behavior by resolving internalized anger and experiencing forgiveness. Thesubjects of the study were four male students from J High School in K City, and a total of16 sessions were conducted from April to August 2023. Food Art Therapy is a study thatexamined the experience of forgiveness and the effects of growth in adolescents withnon-suicidal self-injurious behavior. Food art therapy had an impact on reducingself-harm behavior by increasing the level of forgiveness experience in adolescents withnon-suicidal self-harm behavior. Therefore, it will be possible to understand theself-harming behavior factors of adolescents with non-suicidal self-harming behavior anduse food art therapy to find ways to prevent adolescent self-harming behavior.

Borderline Bireylerde Kendine Zarar Verme Davranışı ve İntihar Girişimine Yönelik Psikolojik Müdahaleler: Sistematik Derleme

Self-harm behaviour and suicide attempts are considered maladaptive coping mechanisms by individuals with a diagnosis of borderline personality disorder (BPD). Numerous studies have demonstrated that individuals with BPD are at a heightened risk for self-harm behaviour and suicide. Therefore, there is a need for intervention efforts aimed at reducing self-harm and suicide attempts in this population by promoting more functional coping strategies. No systematic review has been conducted to explore the effectiveness of such interventions. A systematic review was performed to identify randomized controlled trials of interventions to reduce self-harm and suicide attempts among individuals with BPD, published between 2012 and 2022. PsycARTICLES, PubMed, Web of Science, Science Direct, and Taylor & Francis databases were examined in the review. A total of 6,760 studies were initially screened, only 13 were selected for review based on the inclusion and exclusion criteria. The results indicated that the standard dialectical behaviour therapy protocol, with the addition of psychological intervention components such as skills training, exposure and acceptance, statistically significantly increased recovery. Statistically significant results have been obtained from various psychotherapeutic intervention groups such as schema therapy, cognitive behavioural therapy and emotion regulation therapy However, it was noted that existing protocols might be inadequate in preventing relapse and addressing potential negative outcomes such as premature termination of therapy.